1 MAC-incision sevoflurane prevents explicit awareness during surgical skin incision and tracheal intubation

Background: This study tested the hypothesis that 1 MAC-incision anesthesia secures unconsciousness during surgical skin incision and tracheal intubation. Methods: Twenty patients scheduled for gynecological laparotomy were anesthetized with sevoflurane as the sole agent. At 1 MAC-incision steady-state conditions, the patients were observed for autonomic/movement responses and wakefulness (response to verbal commands) in the 1-min period following surgical skin incision and tracheal intubation. Results: Blood pressure and heart rate increased significantly secondary to both stimuli, and significantly more after tracheal intubation than skin incision. Ten and 19 patients moved in response to skin incision and tracheal intubation, respectively. None of the patients showed wakefulness. Conclusion: It is concluded that 1MAC-incision sevoflurane secures unconsciousness during surgical skin incision and tracheal intubation.